In the process of policy-making and implementation, even the keystone of integrity and truthfulness can sometimes be challenged by our society due to greed and
117 James F. Keenan, “Proposing Cardinal Virtues,” Theological Studies 56
individualism that have penetrated almost all levels of our lives. The third pillar founded on the seventh and eighth Beatitude offers the virtues of peacemaking and kenosis, which we may call proto-virtues due to their overall importance. We highlight two reasons. First of all, moral agents of public health should be well-trained technicians and negotiators capable of providing knowledge as well as having dialogue skills necessary to create an environment suitable for building sustainable healthcare systems. Secondly, they should also be psycho-spiritually ready to offer their life for this purpose—if necessary. In this third pillar, we will show that the virtues of integrity and truthfulness should be more manifest especially when moral agents engage in conflicts that require compromising by way of peacemaking.
II.5.A. Peacemaking in Public Health Ethics
“Blessed are the peacemakers, for they will be called children of God.”118
In the process of crafting or applying public health policies for sub-Saharan Africa, the officials in charge will face many challenges to uphold integrity and truthfulness. As a matter of fact, Sub-Saharan Africa is the most fertile field for exploitations engineered by business corporations or for the work of charity organizations. Moreover, most of this region suffers both from economic and political instability, which creates a favorable environment for corruption practices. With so much corruption and greed producing extreme poverty and death, public health officials or organizations that provide financial support for the building up of healthcare systems in this region need to compromise in negotiations for the sake of the poor. We will now explore how the seventh beatitude will help in this process.
This seventh Beatitude enjoins moral agents of public health to face the contingencies that arise in the practice of their profession with perseverance. In order to climb to the level of facing challenges of this magnitude, one needs to look for Jesus as the answer to the challenge. In fact, Jesus Christ proclaimed it: “I am the way and the truth and the life.”119 Therefore, entering into and remaining in prayerful communion with Jesus Christ—the way, the truth, and the life—will strengthen moral agents of public health in their endeavors to uphold the truth with integrity. How is this Imitation
Christi achieved?
According to Chan, the practice of the virtue of peacemaking is achieved only in the transformation of human relationships and implies the concomitant attainment of the virtue of justice.120 Besides, peacemaking requires as a precondition positive actions realized in bringing peace—peacemakers and not pacifists per se.121 This is where the virtue of peacemaking intersects with the purpose of public health policy in Su- Saharan Africa. As we have already elaborated extensively, urgent actions in the field of justice in healthcare policy and implementation are very crucial in this region. As a matter of fact, in countries where only 2% of the annual budget is attributed to healthcare, justice does not only involve a fair allocation of available healthcare resources but also, and most importantly, the fight for an increase in the annual budget for public health. The officials in charge of financial management, socio-economic strategies as well as politicians should be engaged in a process of dialogue. Chan reminds us that, even as the virtue of peacemaking calls for socio-political engagement, we should always make sure
119 Jn 14:6.
120 Chan, The Ten Commandments and the Beatitudes, 212-213. 121 Ibid., 210.
that we are negotiating with human beings in the first place; not social or political groups.122 Therefore, personal and communal interactions are to come first before social change can take place.123
In the process of peacemaking, the officials will not only have to advance the cause of those in need of healthcare but also they need to engage in acts of transformation of interpersonal relationships with partners in their dialogue. They have to enjoin their interlocutors to embark on the path of the virtue of justice for the oppressed and to make them friends of the same journey. If they engage in authentic dialogue, the result will be mutual conversion manifested in communion with each other. This level of dialogue is only possible when the two sides allow the spirit of God—the true spirit of mourning with the sufferers—to work in them. The spirit of God will be present when the ability to listen and hear the cry of the sufferers and obey their summons are nurtured.
As a result, even as healthcare systems may not deliver their promises immediately, this process, which demands authentic interpersonal relationships, will lead to, using the words of Chan, reconciliation and forgiveness. In most of Sub-Saharan Africa, conflicts of interests among external and internal forces have most often culminated in open armed conflicts, which have had negative effects on healthcare for the poor. The gradual success of the healthcare agenda by way of dialogue between public health officials and the different layers of the population will be a good example of the possibility of peaceful resolution of both socio-economic and political conflicts. This process will also create a kingdom of moral agents of the common good in the strictest
122 Chan, The Ten Commandments and the Beatitudes, 210. 123 Ibid., 212.
sense. At the same time, as the policies will benefit more and more those who are suffering, the latter will grow in trust and sense of brotherhood with the latter two groups. Nonetheless, we also know that in order to attain peace in places where conflicts of all kinds have prevailed for long periods is not easy. Some sacrifices may be needed to truly bring about social change. One of these sacrifices is the readiness to surrender one’s life for the sake of justice for the poor and the marginalized.
II.5.B. Kenosis in Public Health Ethics
“Blessed are those who are persecuted for the sake of righteousness, for theirs is the kingdom of Heaven.”124
We have already discussed that, in Sub-Saharan Africa, the fight for social justice often involves high financial interests at stake. Therefore, in the process of making sure that the poor are not exploited, public health officials may have to face threats to their lives. All throughout our discussion, we have presented the imitation Christi as the ideal modus operandi that has to guide all actions and attitudes of moral agents in the field of public health. At this level where we talk about the possibility of offering one’s life for the sake of those who are suffering, Jesus Christ is the model par excellence. His setting for us as model of self-sacrifice calls all the people involved in public health to find in Him a source of inspiration and strength.
In this process, which has a locus in the common good of public health, the public health officials will have an important responsibility as messengers of Christ, to bring healing to the world. We are now going to follow Hood’s proposal of the three
vocations that characterize Jesus’s disciples to describe actions, attitude and inner dispositions of moral agents, which will define the anthropological profile of public health officials in this process of kenosis.
First, the disciples are, according to Hood, authorized agents who share in the authority of Jesus eternally, rule over all things and, for that matter, are restored to the position that God originally intended for the whole of humanity.125 However, even if the whole of humanity is entitled to the status of discipleship with all the powers that come with it, we have seen that those at the margins cannot fully benefit from this entitlement and lack the power to change the lives of other people. Given that public health officials wield so much power, it may also be important that they reckon that since their power is an authorized one coming from Christ, they are also required to act like Christ. Hood puts it rightly so when he writes: “The disciples imitate Jesus as they work, and they become so identifiable with Jesus and his authority that some of their actions are heaven’s actions, and their presence is his presence.”126
Therefore, this entitlement comes with a price. We know that, after the resurrection, the disciples were left with both the task of preaching the good news as well as the power to heal diseases, to forgive sins, etc. Like Jesus, many of them lost their lives in the course of carrying out these duties. Moral agents in public health should therefore carry out this task not merely as an enjoyment of the fruit of their profession but as a mission from God, which begs for holy obedience and conformity with God’s way of proceeding.
125 Jason B. Hood, Imitating God in Christ: Recapturing a Biblical Pattern,
(Downers Grove, IL: InterVarsity Press, 2013), 66.
Second, according to Hood, the disciples are apprentices. Hood claims that discipleship requires giving up some of the highly valued characteristics of the western culture like independence, comfort, originality and efficiency.127 Hood stresses this point when he defines what this calling involves: “Vocations require an apprenticeship when their task involves something unnatural.”128 He added that the imitation of Jesus’s cross bearing and self-denial is the most unnatural thing and it is the core of Christian apprenticeship.129
How does this unnatural character trait affect and is effected by public health officials of Sub-Saharan Africa? We may say that in a world that so values individualism and competition, the anthropological profile of kenosis summoned by the eighth beatitude will lead those in position of power to experience gradual self- denial by adopting other-centered attitudes—especially when the corrupt world of public health urges them to do otherwise. They should learn to remember that they are apprentices of the imitation of Jesus and that this imitation cannot be brought down to the banal or the normal things of this world—it is a vocation and at its core is the spirit of apprenticeship of the purpose they are called for—to offer themselves as fragrant sacrifices for the physical and spiritual healing of this world.
Third and finally, disciples are ambassadors because they not only follow in the footsteps of Jesus but also are messengers of truth and mercy, judgment and forgiveness.130 How does this relate to kenosis? As already shown above, conflicts of
127 Hood, Imitating God in Christ: Recapturing a Biblical Pattern, 66. 128 Ibid., 67.
129 Ibid. 130 Ibid.
interests, lies, deceits, dishonesty, etc., are rife in the field of public health policy. The public health officials and benefactors who fight for the sake of the common good will have to uphold the truth even as they face threat to their death. As ambassadors of Jesus most merciful, they will also have to practice mercy for those who, because of attempts at the lives of the marginalized have failed through negligence or intentional mismanagement. However, they will also have to uphold justice by way of the virtue of prudence, judging the wrong done, and forgiving whenever necessary.
As people with authority but whose measure of efficiency is Jesus Christ for whom they are ambassadors, public health officials should not shy away from accepting any consequences of actions for the sake of the poor and the oppressed. As we can see here, peacemaking is closely related to the possibility of kenosis.
II.5.C. Conclusion
Chan tells us, since genuine peace is built upon justice, the cultivation of the virtue of peacemaking will produce the virtue of justice as well.131 It appears that if public health officials would be endowed with only the character trait of peacemaking, the right to health would be served. Should we, therefore, advocate for the virtue of peacemaking as the sole character trait most important in the anthropological profile of public health officials? It is good to note that, even if the virtue of peacemaking is very important, the virtue of humility, which we described in the first part of the first pillar, will still be called for. As a matter of fact, in order for those who have more responsibilities and privileges than others to plead for the poor in peacemaking, they still need to practice the virtue of humility in order to rid themselves of spiritual pride and
learn to find God in all things. Only in this way will they be able to listen and take note of the cries of the marginalized and the sick whose needs for healthcare should be constantly satisfied urgently.
According to Chan, solidarity and the virtuous acts of mourning are also related to peacemaking because they imply mutual assistance for the sake of peacemaking.132 Similarly, Chan tells us that meekness and fortitude, which call for patience and rejection of violence, equally contribute to peacemaking.133 As a matter of fact, we have found out that, these virtues are crucial in surrendering one’s comfort and associating with the oppressed, patiently dialoguing with them and experiencing first hand their suffering. There is no better way to start the process of peacemaking than this.
In the second pillar, as we discussed the making of the shepherds of the common good, we saw the importance of developing rightful relationships with God and other human beings and how it is crucial for the emergence and sustenance of God’s righteousness—justice. Further, we showed how mercy as ‘active work with immediate effect of charity’ will be instrumental in avoiding malpractices, which would perpetuate the sufferings of the people. As Chan reminds us in its invitation to practice forgiveness, mercy will also be instrumental for peacemaking.134 In our case, the avoidance of suffering through authentic acts of mercy accompanied with the practices of ‘admonishing the sinner, forgiving the offenses, and bearing wrongs patiently’ are the most important attitudes not only for peacemaking but also for negotiating the alleviation
132 Chan, The Ten Commandments and the Beatitudes, 213. 133 Ibid.
of the suffering caused by unsustainable healthcare systems. As virtues conducive to truthfulness and integrity, honesty, prudence and vigilance are also very important virtues for peacemaking and for avoiding to cooperate with those who exploit the poor.
Finally, we have seen that kenosis is attained only when the moral agent has acquired the previous character traits from the first pillar all the way to the virtue of peacemaking. All these character traits, which describe the moral agents in public health, are interconnected. In the process of public policy-making or implementation, public health officials should assess their thoughts, actions and policies in light of this anthropological profile starting from the first to the third pillar and not vice-versa.
In the following and final chapter of this research project, we are going to apply the personal and social anthropological profile that we have just developed to healthcare for the mentally disabled in Sub-Saharan Africa.
CHAPTER THREE: APPLICATION OF THE THREE-PILLAR VIRTUE-BASED PERSONAL AND SOCIAL ANTHROPOLOGICAL PROFILE OF MORAL
AGENTS IN HEALTHCARE FOR THE MENTALLY DISABLED IN SUB- SAHARAN AFRICA
This chapter discusses the care of persons with mental disabilities and shows that the language of human rights is not enough to secure them the public health programs and policies that are needed. Rather, I argue that human rights language needs to be anthropologically grounded on the three pillars that should robustly animate both the public health officials and society and could lead to responsible and accountable leaders caring for persons with mental disabilities.
III.1. The Problematic of the Ethics of Abundant Life in Healthcare for